| NPI | 1881447514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 374U00000X Home Health Aide (Licence: DC HHA200003467) | |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2025-08-18 |